reprints of articles published in magazines

Sunday, 22 April 2007

The Beautiful Mind

October 10th is the World Mental Health Day. What better excuse can I have to vent my grouse against the media portrayal of the Mentally Ill?!

For the mentally ill have suddenly become the oft-portrayed characters on both the small as well as the big screen. Almost all the television soaps sport a character who is mentally ill. Many films have explored the life of the insane. While one is happy that the media is giving so much attention to mental health, the actual presentation of mental illnesses in the media is downright nonsensical and leaves much room for improvement.

To this day, mental hospital scenes are depicted as places of chaos, where the green clad patients leap around like monkeys, indulge in all kinds of buffoonery, talk like grown up babies and behave like utter idiots. In real life though there is no mental hospital today where patients behave in any way similar to what is shown in the television or the movies. Insane though they are, the patients still are and behave like humans….not at all like the half-cracked up caricatures that are depicted by the entertainment industry.

Films and teleserials also depict the mentally ill as dangerous people. Most films tell tales of the Mentally ill hero going around killing every Tom, Dick and Harry at the drop of a hat. In reality though, most murders are committed by only the so-called sane people; the insane never indulge in such planned violence.

Another major rubbish that is presented in the movies is the abject bleakness of the life of the mentally ill person. According to the Tamil films a mentally ill person will either kill others or kill oneself or do both. There is no other productive activity in his/her life. From Alavandaan to Anniyan, all films make the same mistake of showing the mentally ill person as being permanently malicious. This is completely untrue. In reality most mentally ill persons are absolutely harmless. Many are married, gainfully employed and lead such near-perfect lives that no one apart from their closest family members can make out that they are psychologically ill.

And the worst rubbish shown in such movies is the alleged incurability of mental illnesses. Admittedly certain long-term, genetically deep-seated mental illnesses are difficult to cure, but the vast majority of mental illnesses are all quite easy to conquer. The kind of sophisticated medications that we fortunately have today have made mental illnesses quite treatable. Depression, Mania, Anxiety, repeated bad thoughts, sleeplessness, impotence, fears, panic, chronic aches and pains, bad marriage, child rearing difficulties….you name it and it is all curable. Yet the media goes on with the once-mentally-ill-always-mentally-ill kind of myth.

But that is the not the worst! There is yet another gibberish in Indian movies…..the mentally ill hero of the movies always falls in love with his psychiatrist. If the psychiatrist is an old man, then the daughter of the psychiatrist. No daughter, then at least the niece of the psychiatrist! Romantic as these love-pairings may be to the audience, such cinematised doctor-patient dalliances are down right idiotic. No doctor in his/her right senses would encourage such non-professional liaisons, for to the true doctor the patients are like one’s own children and any erotic involvement with one’s patients is considered incestuous and unethical. And kudos to the mentally ill persons….even in the heights of insanity, they know that the doctor is sacrosanct.

But films are only made for entertainment, we don’t have to take it so seriously, a media enthusiast may well argue….but you know what, research as consistently shown that watching something be it on film, or real can change the human mind. Because the human mind is designed on a see it-do it-learn it model, it learns things even from a medium that is supposed to be offer only entertainment. More violence is reported in children who watch televised violence scenes than those who watch Mickey Mouse.

The unknown artist who made his burnt-clay dolls in the long buried city of Mohenjadaro or Harappa would only have considered his doll-making as an expression of his creativity. But today, we rate that culture’s merit based on his doll-making! Likewise the movie-maker of today may make his movie only to express his creativity, or just to make some money…..but in the course of history, this culture will also be rated based on what he has created. And it is only a civilised culture that avoids hurting the sensibilities of its citizens.

Nearly thirty to forty percent of the general population has some psychological illness or the other. With proper treatment, they would all become better. But even if the treatment is offered free, many people hesitate to consult a psychiatrist, because they fear such consultation will confirm that they are one of those ‘dangerous, permanently damaged buffoons’, shown on TV or the movie. That is how much bad media representation can hurt the sensibilities of the people.

Also consider the effect that such media representation would have on a person who is now on treatment for his/her mental ailment…. let me give you an example.

Name Undisclosed is a young college student who had battled with a schizophrenic illness but became better with medications. He happened to watch a very popular Tamil film and the very next day he reported with complaints of sleeplessness and fear of becoming ‘mad’ again. When enquired he revealed that the movie he had seen the previous day had scared him with its contents. In the movie, the hero loses his control along with his sanity and goes around killing people, yelling in high decibels and generally behaving in a very undignified manner. “Will I also become like that doctor? Will this illness make me lose my dignity?” He asked so pathetically. He was reassured that “the makers of such insensible movies were all Class One Dumb Idiots who do not know the A B C D of mental illnesses. They have finished all their stories about the Extraordinary feats of the Normal Tamil Man. But the problem with being normal is Normal is so boring after a time. And so the moviemakers are all out to create their own genre of the Abnormal Man. Most moviemakers have no knowledge first hand of mental illnesses. They build their grandiose stories based on hearsay, hero-hoisting and imagination, with a profound absence of realism, naturally their depictions would be awful and flawful”…. thus reassured the young man was prescribed a dose of the Beautiful Mind.

Now The Beautiful Mind is also a movie. It is also about a man, John Nash, afflicted with a mental illness…. schizophrenia to be precise. But the movie is all about the hero overcoming the illness and winning against all odds, no less than the Noble Prize.

Name Undisclosed called up the next day, so full of his joy and hope…he was filled with optimism on seeing the movie that he wanted to share his pleasant thoughts with his doctor. That is what a good movie will do …it makes people hope, trust and grow….I wish I could name one Tamil movie that would have the same effect on the mentally ill person!

With some friends in the film industry, we reviewed all the mental-illness-based Tamil films so far made. Of the hundreds of movies thus reviewed, only a paltry two films passed the test. One was Ethir Neechal by veteran director K. Balachander in which despite her brief stint in a mental hospital, the heroine is depicted as shining right through life. The other was Pathinaaru Vayathinile, by ace director Bharathiraja, in which the mentally retarded Chappani overcomes the oddities in his life with determination.

Only two movies! In such a big film industry that makes so many mental-illness-based movies per year….you wonder? Ah, that’s the whole point!

Mental illnesses are depicted very unfavourably in the movies. But with the audience becoming more discerning, let’s hope the moviemakers learn their lesson and grow up to make some civilised movies, at least on the mentally ill.

The Malaysian Man

Malaysia is a beautiful country. One could write pages and pages about its various places of interest but then, all this can be read up from any encyclopaedia or downloaded from the net. What I’d really like to focus upon, is this man that I met in Kuala Lumpur.

I did not notice him at first. I was busy ogling the street scenes that swept past the bus window and exchanging remarks with my friend. As the bus consumed the miles, I tried to strike up a conversation with my Malay neighbour, “Can you please tell us when we reach Masjid India?” The pretty lady shook her head and said apologetically, “No English, Bahasa only”. Just when I was turning away with disappointment, I caught the eyes of this said man. He was watching us with a smile. Just the looks of him and I knew he was a Tamil. The chocolate complexion, the ‘I-know-your-lingo’ looks, the friendly countenance…Ah! To meet your own kind, especially in a foreign land! Our team of peregrinators gave him a unanimous delighted smile. Luckily for us, he was getting down at Masjid India too. At his signal we merrily hopped out of the bus and followed him like the dutiful mice scampering after the Piper.

He led us deftly through the confusing trail, pointed out at the Parliament, the Indian market, the stadium, etc., stopping only to click snaps at vantage points. He gave us quick descriptions about the various landmarks, shared with us the must-know for tourists, garnished with the right dose of humour and biographical details. Soon we reached Jalan Masjid India. He guided us to the ultimate shopper’s paradise: Hanifa stores. Eager to commence shopping, we turned to thank him for his kindness. We assumed that he would part and proceed with whatever work he had for the day. But he seemed to be in no hurry, “Finish your shopping, I’ll wait”. We were taken aback; God knows how much time we’d take to shop!

We tried to explain and politely persuaded him to get on his way, but he stayed put. Anyway we were too eager to shop and could not spare time to think any further. As we jostled up and down the jam-packed aisles, our T-shirt clad Santa Claus kept sensing our needs and guided us to the right spots. In a way, we were grateful to have this grown up Boy Scout around. He was our Malay spokesperson, our security guard, the authority on what to buy and how much to pay, our carrier of heavy bags….he was so helpful!

But then- didn’t he have other things to do? How could he just let total strangers like us, swallow up his time and energy? Every one of us will surely be courteous and helpful to hapless tourists, but wasn’t this a bit too hyper helpful? We were in a foreign land and trust was a costly commodity that had to be judiciously spent. There were women in our team, we had money on us and expensive items had been purchased. Although we did not voice it, we all kept exchanging paranoid looks. We started looking for signs of deceit. We could not find any, he looked like a perfect gentleman, his demeanour was entirely dignified and his only gratification seemed to be our common language. He was too good to be true.

When hunger won over our acquisitiveness, the feverish shopping spree came to an end and we chemotaxied towards an Indian restaurant. A pseudo-friendly Sardar offered us greasy chappathis and unappetizingly priced sabjis. We sat down to have our Thanks Giving Meal with our friendly neighbourhood Malay man.

Towards the end of the meal, we exchanged addresses with our Mr. KL, hinting subtly at the end of our time together. But the hint went wide off its mark. Sans any postprandial lethargy, he zestfully marched us to yet another shopping complex. This time the shopping was not frantic but the need to get away from this overzealous Good Samaritan was. Sight seeing and shopping were relegated to the end of our list, all we could think of was rest and some limb-stretch. We pleaded tiredness, heaviness of the purchases and even bankruptcy. But our honorary guide would not hear of it. He wheedled us to one spot after the other, “You must see the Chinese area la. The nightlife there is beautiful. In the evenings, the streets are lit up……..”

“Please, we’ll see all that some other time, we’re too tired now. Let’s call it a day”, the least tolerant among us asserted and before he could reply, hurriedly hailed a cab. We hastily piled into the Toyota and turned to thank our Man Friday for his time and help. But much to our chagrin, he also climbed into the cab, “ I’ll get down on the way.”

He did not, he accompanied us all the way back to the hotel, helped us carry our huge cases into our room and enquired about our plans for the next day. We were alarmed. His helpfulness was all fine, but why would someone go out of his way to help a bunch of strangers, what was the motive? While we bartered looks pregnant with sinister meanings, the alpha male of our team, quietly led the man out, ostensibly for a drink. With the subject of our predicate safely out of earshot, we verbalised our doubts freely.

“He does not look like a bad sort, perhaps he is just lonely.”
“Lonely for women’s company?”
“Aw! Come on- he is as cordial to the ladies as he is to the men.”
“May be it is our Tamil.”
“He said he’s travelled all over the world, may be that’s why he understands our plight”
“It must have been his day out and he just joined our fun for the heck of it.”
“May be we remind him of his children.”

While we were still debating, our alpha male returned, without our Malay Man. Before we could ask, he pronounced his verdict, “Seems to be a genuinely nice guy. He was only trying to help us. But he had me worried- I mean how can anybody be so good?!.”

On hearing that, I de javu’ised what my paediatrician friend Preetha had once told me, “It is easy to understand why a person is bad – the reasons are obvious. But it is very difficult to understand why a person is good. There seems to be no reason at all for being good. Good simply is.”

I had not quite understood what she had said then. But now, I think I do.

Saturday, 21 April 2007

The BIG and the small

Scene One: The Park Avenue in midtown Manhattan supposedly the most prestigious of addresses. We were staying in one of the glitzy five star hotels right on the Park Avenue…. you know one of those grand de la grand hotels that have gold tinted mirrors in the elevators and gold polished faucets in the bathroom.

We were attending a medical conference in this hyper opulent hotel. And we were told this particular hotel was specifically chosen because it was in the middle of everything that was worth seeing in New York. The Empire State Building was a few blocks this way, the Central Park was a few yards that way, the Rockefeller Building was just a few metres away and the Grand Central Station was a few feet the other way.

But we had so little time to spend sight seeing. The conference was so jam packed with so many sessions that the only time we had to ourselves was after 5.30 pm. But the Empire State Building would be closed for visitors after that…. and we were all so keen on seeing this Wonder of the World.

And so it was decided that we’d spend our lunch break wisely…as soon as the meeting broke for lunch we’d all rush to the Empire State Building, quickly look over the wonder and rush back in time for lunch and the afternoon sessions. Likewise immediately after we dispersed for lunch, we ran across the fifth avenue all eager to behold the big building. Once we entered the Wonder Building, we ogled around and walked over to the ticket counter. There a wise guy in our team had a brilliant idea. He said “For seventeen dollars we get to take a virtual plane ride through the city of New York and also see this Building. Only ten minutes…let’s all do the virtual city tour too!”

He wheedled, coerced and peddled the idea so vehemently that we all agreed to join the show…it turned out to be some dumb video show fit to amuse kids below six years or less. And we had wasted some precious ten minutes. Yet politely as would befit psychiatrists we withheld out collective irritation at the wise man that gave this stupid idea and walked over to the elevator to go to the top of the Wonder Building. From the top we could see the green patch of the Central Park, the Blue silhouette of the Statue of Liberty and the many skyscrapers of Manhattan.

We swarmed back into the elevator, went down and out of the building and walked back to the hotel. Being the faster walker of the lot, I outpaced my gang and went into the hotel, all hungry and thirsty. I walked into the banquet hall where our lunch was to be served…and to my big surprise, all the tables were cleared and there was no food on the buffet. There was a lone steward tending to the empty tables, I walked up to him, showed him my identity badge, introduced myself and explained that a bunch of us were yet to have our lunch. We were all the delegates attending the meeting and this lunch had been specifically arranged for us…. naturally we expected our share of the lunch to be saved up…we were just on time for lunch anyway.

But the steward gave me a superciliary look, pointed at his watch and said “Lunch time is just over”. Superciliary look my foot, I stared back at him and said very clearly, “But we are hungry. Let us have our lunch.” He went back him and brought a senior steward, now this guy looked up and down at me and finally said, “All the food is over.”

I was taken aback, “I am sure you arranged food for all of us. But most of us have not eaten. Surely there must be something remaining”

Senior steward looked at me, I looked back at him very determinedly. Finally he said in chaste Americanese, “Well, there is some soup left”

“Fine, let us have that”

By then the rest of my team had arrived, but all that we were given to eat was some soup and left over bread. This, in the finest of five star hotels in the heart of the wealthiest city.

Scene two: Another five star hotel in Kuala Lumpur. This hotel offered us bed and breakfast deals only and so we had to find our own means of food for lunch and dinner. Luckily right opposite the hotel was a street corner food shop run by some immigrant Tamils. All the days that we stayed in KL we had sumptuous parotas and cold Milos under the awnings of this street side restaurant, enjoying our lingua madarasi conversations with the restaurant personnel. The restaurant owner gave us many useful tips on The Best Place to Shop, The Must See Places and The Must Do Things in KL, etc.

On the last day of our stay in KL we had our Last Lunch at this restaurant. But one of our team members had been so bitten by the shopping bug that he had spent too much time at the malls and missed the lunch. He arrived two hours after our regular lunchtime laden with shopping bags but complaining of “Semma Pasi”.

We took him to our street corner restaurant. The owner looked up and asked, “So late? But we’re closed. Not had food yet?”

“No, lost track of time shopping. Anything to eat?”

“Sure”. He pulled up chairs for everyone. Brought some chappathi and sambar for the late eater and mugs of Cold Milo for the rest.

“What combination is this? Chappathi and sambar?” The late eater made a face as he munched the food.

Without much ado the restaurant man said, “I am sorry…it is not restaurant food. This is my lunch…”

We looked up at the man in surprise, “Your lunch…but what will you eat? You should have told us!! We would have gone elsewhere”

“No big deal. Please go on and eat. I’ll manage”

And so we resumed our regular chatter. When the meal was over we got up, said ‘thanks’ and paid up the bill. But on seeing the bill we noticed that the chappathi and sambar had not been charged. We promptly brought that to the notice of the hotelier.
“I know.” He said nonchalantly. “It is not hotel food….that’s why I didn’t charge it”

This, in a street corner eatery in some obscure developing nation.

The smallness of the big and the bigness of the small…. it never ceases to amaze me!

Ode to the teacher

Come teacher’s day and it is a time-honoured tradition to reminisce about one’s teachers. Many teachers have come and gone in my long years of student hood, all of them have taught me things from the various text books, but the teachers that I always remember are the ones who taught me things that are never written down in text books.

Well, there was this teacher that I had in my very early days of schooling. Her name was Julie something but the little kid that I was, I remember her only as Julie Miss. I happened to be a good student then, but during one of the exams, I fell sick and went off to school with a high fever. I had to write down the Tamil alphabet and I do not know if it was because of my low IQ or the high fever, but suddenly I forgot all about a, aa, e, ee. There I was sitting with a confused look on my face….and this Julie miss just appeared beside me like a guardian angel, looked at my face and without a word, pulled out the pencil from numb fingers, scribbled the entire alphabet on the exam paper and said, “It’s OK, you go home now.” Even my febrile disoriented brain, knew what she did was not exactly right….a teacher ought not to help a student like that, when the exam is specifically meant to test the student’s memory skills. But Julie Miss was more concerned about my health than the meaning of exams. That was the first non-text-book lesson of my life: Rules are all fine, but humanity and kindness come first.

Teachers capable of instilling such profound lessons must be a rarity, for it took a few more years for me to learn my next such lesson. We were studying in Sixth Standard D section then, D for Devils as my class teacher used to tell us ever so often! Our regular history teacher was on leave and we had a substitute Miss. This new teacher found us too devilish and decided we needed to be punished. So we all had to Stand Up On The Bench for her. But she still found ‘some noise coming’ and decided to increase the degree of the punishment, by taking us all to the Principal for admonishment.

I happened to be on the first row on the right, next to Shiny and Satish. Shiny being the first, she had the privilege of leading the line to the Principal’s Office. The teacher gave Shiny a stern look and said “Get Down and stand in the line”. That was enough to make Shiny cry. But tears did not seem to help, Shiny was made to leave the class and stand outside. Next it was Satish’s turn. He tried to buy time, fidgeting and pleading, but the teacher seemed clear in her intentions…so Satish got off the bench and went to stand behind Shiny. “Next” the teacher said, turning to look at me. Well, it seemed certain that we’ll all meet the Principal that day, and since there were two people ahead of me in the line, I did not see any point in wasting time on the bench. I jumped off the desk and went to stand behind Satish. The teacher was furious. She called me back and asked, “Are you not afraid of going to the Principal’s Room?” I shook my head and said “No”

Why would I be afraid of my own Principal! Our Princi Mrs. Mohana Chandrasekaran was to me the Role Model Woman; she was so cool, smart and so kind…. I simply loved to look at her! And when the entire class was there to add safety in numbers I really did not see it as scary at all.

That I was not afraid of my Principal seemed to make the new teacher livid with rage. She withdrew the ‘Stand up on the bench’ and ‘going to the principal’ punishments and made the entire class write “I will not make noise in the Class” twenty five times. For me though, the imposition was for a hundred times. The twenty five times writing took less time, so the others left…and there I was sitting all alone and painfully writing “I will not make noise in the class” a hundred times.

My English teacher noticed my solitary writing and entered the class to enquire why I was still there. When I explained the problem Miss Malathy Ramaswamy who for God knows what reason had a good opinion about me, became very upset. “It is Ok for you to be fearless my dear, but sometimes, you must at least pretend to be afraid…otherwise people take it as a challenge and become all the more cruel.”

That was lesson number two: That Discretion is the better part of valour.

The third lesson came about when I was in my ninth standard of school. Again it was a Tamil exam and we were to write a composition on the Beautiful Landscapes of Kutralam. I was in the peak of adolescence then, even otherwise I was the cranky kid with naughty ideas…and Tamil was so difficult, it had three Naa’s, three Laa’s and two Raa’s- I never knew which came where! It was only my first year with Tamil as a Second Language, writing a full composition was so daunting a task….so I ended up writing a Tamil film song that describes the mystic beauty of nature, interspersed with my comments on that song. The exam was written and the paper submitted when my classmates told me that the Tamil Teacher was the strictest person in the entire campus. She was a no-nonsense lady, who also happened to be the Vice principal of the school. When I mentioned my film-based composition, my seniors gave me a gloomy look. “What have you done? She’ll surely issue you a TC now!” The entire class was anxious, nobody had ever got a TC before and everyone wanted to know how exactly it was done.

A few days later, the Tamil teacher walked in with the exam papers. The whole class became charged with suspense and I became the cynosure of all eyes. The teacher called out each student’s name and handed the corrected papers. My turn came, I walked up to her with a leaden heart…she did not even look up, just handed the paper. What did that mean, would the TC be given later? Confused I went back to my seat and threw the dreaded test paper on the desk. My neighbour picked up the paper and opened it. “Ah! This can’t be!” she immediately exclaimed. What the….I took a look and to my greatest disbelief the Tamil Film Song with all its spelling mistakes was scored 15/15 with a Very Good beside it! My entire class was disappointed….there was no TC for one and film songs were being marked Very Good, that too by a teacher who was supposed to be a strict disciplinarian. And to top it all, at the end of the class, the teacher called me aside and gave me instructions to participate in the next upcoming Tamil Poetry Competition. I was completely stumped! But managed to grasp the lesson that Mrs. Kalyani Varadharajan, so casually taught me: to look beyond the obvious flaws and find the inner beauty in life.

Lesson number four happened when I was in the twelfth standard. We the students were to organise a Science Exhibition. My team was assigned to make a model of the Cave Habitat. Our Biology teacher provided us the chart papers, paints and brushes to make the cave. Our team armed with the painting paraphernalia bent over the many pieces of chart and tried to colour it cave brown. Losing patience with the little brushes and their sparse strokes, I just sprinkled paints of different kinds on the paper and smeared it all with my hand. “Look, this is much quicker” I laughed as long stretches of the chart turned cave brown. But my teammates were terrified, “Just wait till Miss sees what you’re up to! This is not the way to do it….” my teammates were protesting when Mrs C. R. Vijayalakshmi, entered the room and walked straight to us. Instantly I hid my hand behind and waited for the scolding that was sure to come. Of all the charts laying on the table, the teacher picked up the ones that I had hand painted and asked, “Who did this?” All the girls turned to me and I was literally caught brown-handed. The teacher took one look at my hand and said, “Wonderful. Now finish the rest quickly” and walked away to inspect the other projects. I was flabbergasted and my teammates were shocked! But the lesson I learnt that day was: it’s Ok to be non-conformist, as long as one gets the job down well.

After the twelfth standard school days ended. I was off to one Medical College after the other to become a doctor and then a psychiatrist. Medical colleges had no teachers; only tutors, lecturers and professors. Of course the tutors, lecturers and professors were much more qualified and learned than my schoolteachers. But when it came to teaching lessons for life, my schoolteachers were simply the very best! To them I owe all.

A Rose by any other colour

six year old ram insisted that he have a bath everyday- even when he was sick. Not that it was unusual in anyway - but living in the ever cold northern hemisphere as he was, his sudden cleanliness frenzy seemed odd. Ram took to scrubbing himself repeatedly and kept smelling himself often. His mother dismissed his new fad as a passing phase. But she could not likewise dismiss his poor show at school. His latest report card left much to be desired and that was something very atypical. His drooping grades made his mother pull him up for a gentle "trouble shooting talk". It was then that Ram found the courage to ask, "Mom, do brown people stink?" The mother was alarmed, "who said so?". "Them boys at school. They keep teasing me, say I'm brown, so I'd stink...tch! I wish i were not brown. I wanna be blonde like them" said Ram in chaste Americanese. The mother was upset. As a lone brown kid in an international schook, she knew her son would have to face such discriminations bravely. His quivering voice made her want to reach out and smoothen his troubles - but she did not know how, she could not change his skin colour, could she?

Our Paals, the strongest!

Come March 8th and it is a time-honoured tradition that we celebrate the International Women’s Day by singing the praises of some Great Woman who has achieved Something Truly Great. Let me toe that conventional line and sing the glories of my Favourite Woman Achiever.

Her name was Shantha, but not a single soul in all of the Post Graduate Medical Students’ Ladies Hostel knew her real name. She was better known as Paals, short for Paalkaramma.

Paals was that typical village belle, that precise symmetry of her well toned body, that charming chocolate complexion, those natural steaks of bleached hair on her otherwise black alli mudinja kondai, those fine-as-porcelain delicate white teeth….a little more effort and she would have been a real beauty. But then Paals was a widow who believed that a self-respecting widow should make an attempt to look as unsightly as possible. And so we always found her dressed in faded blouses and thread bare kandaangi sarees. She was frankly indifferent to her appearance.

She was a thorough bred illiterate who hailed from a long line of illiterates from a tiny village near Madurai. As was the custom in her village she had been married off to her cousin immediately after she became a big girl. Which must have been when she was fourteen years old or so. This husband of hers turned out to be a daytime gambler, a nighttime drunkard and a part time wife beater. Yet he had been an expert in all other aspects of husbandry and soon after marriage Paals had become pregnant.

Illiterate, young, pregnant and naïve as Paals had been, she expected her husband to change into a good man one fine day…but that fine day never came. Every day was as unfine as the other with her husband regularly battering her for money. Paals had had no one to turn to. She came from a family which considered women burdens, so much so that killing the baby girls as soon as they were born was an everyday non-incident in her village.

Going back to her parents for help was unthinkable….yet putting up with her cruel husband was unbearable too. Not knowing what to do, but very sure that she did not want to continue suffering her marriage Paals walked away. I mean just walked away…. all the way from her village to the next town. With whatever little money she had she boarded a bus to Madurai.

Impulsive, rash, unplanned though her decision had been, she was clear on one thing….never again would she contemplate living with her husband. Enough was enough! Or so she thought when she reached Madurai, the strange city of which she had only heard. She knew no one there. She had no money on her. She was weak with hunger and the fatigue of the long journey. And to make matters worse as soon as she landed there she started having labour pains.

Some kind passers-by rushed her to the government hospital. The doctors there examined her and told her it was only false labour pains…she still had three months to go before her delivery. Three months to go…and there Paals was with nowhere to go. She ambled out of the labour ward wondering what she would do next…when she noticed all the mothers-to-be calling out in pain and gasping out for “something to drink” with their mouths parched sand-paper-dry, what with their hoarse labour- yellings. Immediately Paals seized on the idea and spoke to the ayahs in the ward. She told them her sad story and pleaded for some money. With the money that she thus collected she purchased a bulk quantity of milk and went around the labour ward selling it to the mouth-dry-mothers-to-be.

She must have been quite a sight to behold. A fifteen-year-old wisp of a girl, with her fully pregnant tummy walking around the wards selling milk! The very sight of her would have melted the hearts of the women therein…it is no surprise then that Paals new business picked up fast. So fast that Paals ran into trouble with the established male vendors of the hospital, who found their clientele getting quickly siphoned off by this upstart female entrepreneur. They ganged up together and told her that selling milk - not only milk, peanuts, eggs, rose murrukku and sundal – for by this time, Paals had diversified her modest business, without a license in a government hospital was a big crime. If she did not stop it immediately she would be sent to prison, or so she was told.

But then Paals was a never-say-die-kind-of-person who could swing her greatest weapons – her well endowed lachrymal glands – into action anytime she had a problem. The prison threat brought on a Great Deluge of tears and a big wail of Oppari. Her loud oppari made the doctors rush out to see what was so wrong in the labour ward. One look at her brimming eyes and the brimmier tummy…. all the doctors joined together to shoo away the men who were harassing the poor little pregnant girl. From then on, Paals became the doctors’ pet and was given unspoken unlimited access into the hospital premises. She and she alone was permitted to sell anything, anywhere, anytime. With the entire Department of Obstetrics and Gynaecology backing her so strongly, Paals soon became the unrivalled Paalkaramma of Government Rajaji Hospital, Madurai.

It was then that she had her real labour pains and gave birth to a little one. On seeing the post card that announced the news (written by a benevolent nurse), Paals’ mother rushed to her daughter’s bedside. But when she noticed that the newborn was only a female, the grandmother was very concerned. “Did we need another burden now of all the times! You better feed her some paddy kernels…. she’ll be gone in a minute. No one needs to know that you ever had her. Let me see if I can get you remarried…”

But Paals did not find the courage to feed her daughter with the paddy kernels. Nor she thought, did she have the courage to raise the kid single handedly. Not knowing what to do, she just let the child be, without feeding it…hoping it would die on its own.

But die the child did not…it cried so loudly, so continuously that the whole ward turned to look at Paals…the girl who provided milk to the entire hospital but refused to do the same to her own child. The nurse noticed the commotion and commanded that Paals feed the infant. Unable to stick to her resolve, Paals finally relented and began to feed her baby.

The moment she started feeding the baby, Paals said she felt everything change inside her. She began to realise that without her daughter her life would have no meaning…. her sudden insight gave her a new strength. “For you I’ll live,” she had told her baby daughter and the very words filled her mind with a new sense of purpose.

With renewed enthusiasm she resumed her one-woman-milk-business. The other little woman tucked into her mother’s saree, won so much admiration and sympathy that soon, Paals was offered a job at the Ladies Hostel.

In the beginning Paals job at the hostel had been about ayyahing around only…. but by the time I joined the hostel as a post graduate student, Paals had risen in her ranks and was the unofficial Dean cum presiding deity of the Ladies Hostel. Her daughter had by then become a beautiful sixteen-year-old.

Soon after my arrival in that hostel, Paals and I became close pals. As the hostel secretary cum resident psychiatrist, my room became her first port of call whenever she was in distress. And by definition, distress to Paals would be any move made by anyone that could potentially weaken Paals hold over the hostel. A new mess man who refused to let her sell her Sunday special delicacies, because it made his business pale; a cable TV guy who volunteered to get pots from the market to store cool water; the paper boy who wanted to buy old papers from the hostel….. wherever there was money to be made, Paals made sure no one entered her territory.

And needless to say, she had a magical way with money….a pot that normally cost ten rupees in the market would become twenty rupees apiece when Paals got it for us. Sunday special chicken made by the mess man would cost twenty rupees and it was made in God Knows What Kind Of Oil. But if you asked Paals to cook it for you, she would do it right in front of you, with the best oil and what’s more, it would cost only fifteen rupees per person.

It was not that we were blind to her guiles…but we let Paals be because, we liked her too much. She was money-sharp and word-blunt, but if one of us fell sick Paals would be the first person to rush to our aid, give us a dose of native treatment and straighten us out for our next day’s non stop stint in the wards…. all this was for free.

Her end of the day relaxation routine was to sit beside me during my solitary meals and share her life’s little dreams with me. Dream One was to get her daughter married. Dream Two was to get her daughter married well. Dream Three was to get her daughter married so well that no one would deride the bride for not having a father. Paals life was all about getting her daughter married. Period.

One day she announced to us that her dreams were finally going to turn true…. she had found a suitable boy for her darling daughter. The boy was a relative of hers who worked somewhere in the Gulf Countries. The wedding was to be held in her village. She would arrange a bus for all the doctors in the hostel to go to the wedding…and no, we could not arrange or pay for our own bus. It was her daughter’s wedding and she and she only would arrange for the bus. We only had to board the bus and go to the wedding.

We decided to humour her and the whole lot of us boarded the special bus. At the outskirts of her village we were made to get down, Paals told us cheerfully that we could walk our way into the village. “But it is one kilometre away. The road is good, why can’t we go by bus?” we were curious to know.

“No ma, I’m telling you, this is better. We’ll walk” so saying she led us on a merry procession, showing us off to her dumbstruck villagers who just could not believe that so many doctors were coming from the city just to attend Paals’ daughter’s wedding. Ah, but then, Paals and her shrewdness never surprised us!

We also realised that we the doctors were officially filling the gap of the long dead bride’s father. Paals always had worried that people in her village would take her and her daughter for a ride because she had no one to back her, no men to ward off dangers…. we were her pseudomen, the powerful city doctors who would protect Paals to posterity.

Once we realised our role, we played it to the full. We met up with the mother-in-law-character, who looked like she needed some veiled threats anyway. We gave her an earful on how powerfully connected we city doctors were, and how we would do anything for Paals and her daughter.

That done, with a grateful smile Paals took us around to show all the seer items that she had given her daughter. The poor woman with her modest means could have given off only some simple seers…. but we did not want to hurt her and so went along to see the seer…and lo! Crammed in the room was the grandest seer I’ve ever seen in my entire life. Iron, steel, brass, bronze, copper, terracotta, plastic, aluminium, wood, glass…. you name it and it was there. From big cupboards to small hooks- she had bought everything under the sun. It was like the bridal shower of a princess, no less! And Paals was only a lowly servant. How much she must have worked and saved, to give her daughter this great bonanza.

“How is it ma? Is it ok? What do you think?” Paals was eager for some appreciation. Poor Paals…this had been her life’s dream. We were only too happy to shower praises on her, “Well done Paals. It’s all so terrific. We’re sure the entire village is astonished to see all this. How come we never realised you were so rich!”

Paals beamed with pride. After all it was the day her dreams had come true. All three of them.

Her dreams might have been small time and simple. But considering that she started out with practically nothing, not even an education or the support of her own family, Paals’ success to me seems truly great. Just a milk-seller and an ayyah, she might have been, but to me, she has always been a Role Model on How Women Should Be. Our Paals the strongest!

The shrink and the client

Perhaps, it has happened many times to many people in the mind mending profession, but the first time it happened to me, I was suitably stumped. Well, there was this lanky young software professional who was so sociophobic that he decided to attend a soft skills training programme at my centre. There I was diligently training him in assertiveness, emotional intelligence, transactional analysis, kinaesthetics, etcetera etcetera, when one fine day he announced a new problem. He was having trouble concentrating at work, as he was obsessed with the image of a woman…. And with many a hiccup he blurted out that the woman haunting him so was me. He painfully professed the deepest love he had ever felt and I for once was speechless!

As I lapsed into Mode Mute, busy racing through my mental algorithm trying to figure out the best possible management of this emotional malady, the patient exhausted his rendering and looked up at last. I promptly told him that I needed a second opinion from a senior psychiatrist regarding this new complication and bid him adieu for the moment. I consulted my mentor and put forward the great idea of referring the patient off to him. Mentor mine refused to be saddled with Mindwreck mine. He predicted that I would have to handle more such similar complications in my psychiatristyears ahead and advised me to psychoanalyse this and such other patients out of this Appreciation Superfluxitis. Which I did. But during the course of this Transference Management I inadvertently slipped into bouts of deep introspection. And could not help but ponder over how my male colleagues handle the converse of my situation.

I had of course heard earfuls about doctor- patient dalliances, of various degrees of trespass from various sources. There are umpteen non-specific hearsays of male doctors making lewd innuendoes to their trusting lady patients. Specific cases include this particular lady who whimpered about her previous psychiatrist’s polite request to fellatiate him. Then there was this social welfare officer who expressed disgust at the indecent proposal made by a psychiatrist to a recently bereaved widow. Reports also abound about this senior shrink who in the name of an in camera Mental Status Examination, makes furtive groping of the sound bodies of unsound minded women. There are, I hear, quite a few shrinks who go on to the extent of establishing non-therapeutic alliances with their clients, some all the way up to marriage. Also around is some news about gay doctor- patient liaisons.

Conspicuous as the male slant of the graph seems, one wonders if the women patients in all these instances were truly guileless or is it the case of cotton instigating the fire. For there are also many reports of female patients offering more than just their minds for examination.

The other dimension is the less remarked about lady doctor versus male patient relationship. Does the paucity of grapevinery about such liaison merely indicate paucity of practising lady psychiatrists? Or as many lady psychiatrists confide- troublesome male clients are more likely to turn crude and play, “Me Tarzan, you Jane”, kind of who’s-the-boss-here games. Does such machismo cause more irritation than ignition of passion, which then by negative feed back seals off opportunities to indulge in Professional Incest? Or are the lady shrinks too fastidious to consider coquetting male “after all” patients. Or are the ladies too smart to be heard about? Or is it the ‘No Testosterone = No Philandering’ Equation?

That made too many questions for Small Mind Mine. I spoke to some very erudite shrinks about this. One of them narrated his experience with a lovelorn lady patient who even on the day of her wedding insisted that the good doctor be there to expunge her grief of marrying someone else.

Another shrink told me about his histrionic client who repeatedly let her saree fall off her shoulder. When he nonchalantly ignored the lavish spread, the woman got so pissed off that she called him a “ No Man”. Of course, our man remained completely unruffled.

One other male shrink told me about his unwed wrong-side-of-thirty patient who pleaded with him to give her a baby to satiate her maternal longings.

There are plenty of stories of sexually frustrated women throwing themselves at their doctors - shrinks or otherwise. As also are instances of shrinks using their bodies rather than their minds to treat sexual dysfunctions of their clients.

Such prevalence of this occupational hazard calls for collective introspection on the Other Side of the Shrink-Client Relationship. Why do clients fall for their shrinks? Well the answers range from Positive transference and Negative self Image, to Supplication display, dominance-submissiveness dynamics, people- pleasing tendency, sense of indebtedness, and the lot.

Sometimes it so happens that the client does not actually fall for the shrink, but is merely trying to use sexual invitation displays to win favours such as better treatment, lesser fees, more time spent, etc. Such remotivating tactics, ethologists opine is quite common among mammalian, especially the primate, species.

That answered, there comes the more important question: Why do shrinks fall for their clients? The answers go all the way from reckless impulse, malnourished ego, porous superego and run-amok hormones, to the “no-one’ll ever know” certainty, intimacy versus isolation complexes and the underlying primeval lust.

That also answered, there comes the most important question: is it okay for the shrink to have a toss with his/her client? And this time there are no multiple answers, the unequivocal answer is NO. Whatever the reasons or the explanations, even the perpetrators of such acts consider it immoral and unethical.

For plain and simple human beings, abound with basic instincts, we may all be. But when it comes to being a professional mindmender we are expected to transcend above the human realm and take an extrahuman stance. We are to uphold the nobility of our specialty, by practising Professional Impotence. We are expected to be selectively immune to all the temptations of the client - flesh.

It goes without saying that such compartmental libidinal cathexis is not easy to come by - to remain keenly reactive to our senses outside of the sexual sphere, yet synchronously suppress the eros in our psyche - is quite an oxymoron in itself. The startling finding is, given the improbability of such selective asexuality, it still happens to be the default mode in a majority of us psychiatrists. And that singular distinction makes me marvel - not at the incidence of sexual indiscretions among shrinks, but the lack of it in the vast majority of us. Kudos people – that makes yet another just reason to be proud of ourselves!

The Other Side of the Doctor Patient Relationship

The doctor –patient relationship is one of the most sacred and truly rewarding of all alliances. Millions of people all over the world enjoy good health all thanks to the positive therapeutic alliance that they have with their doctors. Yet this beautiful relationship can sometimes go sour. Thanks to the ubiquitous unpredictable vagaries of Human Nature.

What I’m about to tell you now, might shock you out of your wits. So gather your strength together and listen to these stories…of course, professional ethics demand that I conceal the true names of the protagonists. So I shall tell you no names, just the tales.

Tale One: She had been suffering from piles or Haemorrhoids as it is called in the medical jargon. Unable to bear the pain yet unable to meet expenses at a private clinic, she went to the out patient department of the government hospital. She was history-taken, examined and referred off to the Surgical department. Luckily for her, the surgical department had a lady surgeon-in-training. The patient was examined by the surgeon in the making, who opined that a surgery would cure the problem. The patient got admitted, underwent the routine blood tests, ECG and X Ray. A panel of anaesthetists examined her and found her ‘Fit for Surgery’. She was given an appointment for surgery on the Theatre Day.

In the theatre, the patient was disrobed, disinfected and draped with sterile clothes. Then she was made to lie down on the operating table, with only a loose drape over her body. She was told to turn to one side, curve her back into a neat C and Zschick! A needle inserted into her spine benumbed her from hip downwards. She could not feel anything below her waist. The patient was then turned face up. The lady surgeon propped the patient into a convenient position and bent over to remove her haemorrhoids. While the surgeon was intently cutting and suturing the unwanted tissue, the patient started to squirm. The doctor straightened up to see why the patient who could not possibly feel any pain, squirmed so much. The patient raised her hand and mumbled something behind the oxygen mask on her face. The anaesthetist mumbled something about insufficient anaesthesia and gave a quick injection into her intravenous line. The surgeon went back to work.

The postoperative period was uneventful: no fevers, no bleeding, no infection. The surgeon was happy with her handiwork and a day later went to change the wound dressing for the patient when the patient asked the surgeon: “I raised my hand during the surgery, why didn’t you notice?” The surgeon was perplexed.

“So why did you raise your hand, tell me now?” She enquired politely.

With her eyes brimming over the patient whispered, “The man standing beside me…he was fondling me. I had a drip on one hand…could not stop him…I hoped to draw your attention. But…” the patient burst into tears, unable to narrate the horrible incident any further.

The surgeon was horrified.

Tale Two: She was complaining of vague problems like poor sleep, absent mindedness, sudden urge to walk out of the house and just go away somewhere, recurring bad thoughts and lack of interest in life. For each of these complaints she had met several doctors but nothing seemed to work…she remained ill for long. Exasperated her husband brought her for a psychiatric evaluation. The patient told the shrink all about her physical problems and was duly given medication.

But none of the medicines worked and the patient was still suffering from “got to get out of the house” syndrome. The psychiatrist decided it was time to delve further, set a long appointment and began to probe deep into the recess of the patient’s mind. After a lot of hesitation and many bits of distracting information, the patient finally began to trust the therapist and opened up: “My cousin, he used to misbehave with me. I was unable to protect myself. Finally I found the nerve to stop him. But even after all that stopped I felt tainted. I started having headaches. I was taken to this doctor….”

The patient closed her eyes and laboured hard to breathe, “This doctor, he misbehaved with me too! I was terrified. What is it with me, that makes men behave bad with me…” so saying the lady started to weep. “How could he do that! He was a doctor for god’s sake. He should not be misbehaving with his own patient!”

True. A doctor ought not misbehave with his/her patient. Because a doctor is like a parent…like a father or a mother. Just as it is formidably incestuous for a parent to get sexually involved with his/her own child, it is wrong for a doctor to use his/her patient for sexual gratification. It is a kind of professional incest. It is unethical and is a punishable offence.

But before you jump to conclusions and raise slogans against them Bad Bad Doctors, let me quickly tell you the Tale Number Three: She was a nervous bride-to-be. Her fiancé was constantly cajoling her and talking dirty over the phone. She was shocked that men could be so gross and refused to get married. That made her parents bring her for a premarital sex education session.

In the mean time, she developed pain on her right side of stomach. She was referred to a surgeon. He suspected Cholelithiasis, which is Medicalese for Stone in the Gall Bladder. The surgeon wanted an ultrasound scan of her abdomen. The radiologist was summoned.

Now this radiologist was a thorough professional. He kept a lady nurse by the patient’s side and proceeded with the scanning. The girl’s clothes were parted to reveal her abdomen and the lubricating gel was applied to her skin to make the scanner move smoothly. The radiologist dutifully peered at the granular image of the girl’s abdomen on the monitor and moved the scanner down to check her pelvic organs, all the time reporting his findings to the nurse.

Suddenly the patient jumped up on the examination table and screamed, “Save me, this doctor is disrobing me!” The next moment the entire hospital staff was assembled inside the scan room. The radiologist was completely bewildered. So was the attending nurse…the doctor had had not even touched the girl, not even looked at her, all he did was roll the scanner and check out her organs on the screen. But the patient accused the doctor of pulling away her pavadai. The doctor was aghast. How could he scan with the pavadai on? The patient had been adequately covered with sterile cloth to protect her modesty, moving the pavadai would not have endangered her chastity. Yet the patient raised hell and the psychiatrist who first referred the patient was immediately summoned.

The psychiatrist was the only one who knew about the patient’s undue fear of sex. The patient’s over reaction to the radiologist’s clinical move made sense to the shrink. But the surgeon and the radiologist did not want such a ‘damaging’ patient on their hands. “God knows what she’ll accuse us of next, you know how the laws are, men have absolutely no protection,” they said. Which is completely true too. Levelling false charges against doctors is not an uncommon occurrence, it is not that patients are always correct.

Taking about correctness and incorrectness, directly leads us to Tale Number Four: This doctor was a very kind, duty conscious gentleman. All his patients just loved him. More so one of his lady patients. She was married but had no children as her husband had immotile sperms. The lady was very anxious to conceive and for some reason desired to have the doctor’s children. She decided to take the plunge and one fine day poured her heart out to the doctor. The doctor being the thoroughbred professional that he was, politely but firmly declined the request and advised the patient to consult another doctor henceforth.

The lady became all the more anxious and literally threw herself at the doctor, pleading for his forgiveness and the much-desired baby. Now the doctor was in a fix. He did not want to embarrass the lady, but she was becoming a nuisance. Finally he called his nurse and requested her to escort the patient out. For weeks after that he was hesitant to see female patients. Even when he saw them they appeared to him as potential man hunters.

So you see people, the doctor-patient relationship is like any other relationship – complicated! But there are some time-tested ways to keep it uncomplicated, straight forward and strictly business-like.

1. A lady patient should not be examined by a male doctor unless he is chaperoned by another lady. That is a rule in medical practice and righteous doctors always follow that. Doctors frequently request a lady nurse or an ayyah to remain in the examination room, to reassure the female patient that he is only being clinical. If your doctor forgets to bring in a lady attendant for whatever reasons while examining you, politely but pointedly request for one. Or better still, take someone along with you.

2. However familiar you are with your doctor and however sweet your doctor might seem to you, do not let your doctor touch you in the wrong places. But such a blanket advise needs a disclaimer too. Do not become paranoid and distrust your doctor’s every move. For generally doctors are gentlemen, it is only some loose-moralled men who misbehave, whatever profession they are in. Unfortunately some of these LMM become doctors too! One must be on the guard against such men, but one must also guard against unnecessarily suspecting harmless men.

3. Sometimes patients sense that the doctor is not being completely professional, but in their embarrassment just remain quiet. But remaining quiet can sometimes be mistaken for consent. So if you feel uncomfortable say so.

4. On the other hand, even if the patient consents and is willing to have a sexual relationship with his/her doctor, it is unethical for the doctor to indulge in such activity. Sometimes an ex patient may take a liking to the doctor and consider a not-so-professional-relationship with the doctor. But present or past, once a patient the person is off bounds forever for the doctor. For even if the doctor sees the patient only once, the doctor-patient relationship is forever. It is not for nothing that Medicine is called a noble profession, you see!

5. Some patients feel the need to get into the good books of their doctors. The reasons for this could be any thing from a need to be please the authority, a bid to attract the smart doctor or just an effort to reduce the fees. Just as there are reports of lady patients being abused by their doctors, there are reports too of patients trying to seduce their male doctors.

Of course the doctor ought to maintain what is called Professional Impotence and not succumb to the temptation offered by such women. Most male doctors actually feel insulted when a lady patient displays invitingly at them. But then, we do not live in an ideal world; for every thousand ethically clear, morally upright and professionally virtuous doctors, there may be one or two morally bankrupt ones who do not mind mixing pleasure with profession. It then becomes the lady’s responsibility to ensure that she does not even unwittingly give out any invitation signals.

6. If in spite of all these precautions, a doctor does misbehave, then it is the duty of the abusee to report this to the authorities. Unless checked, the abuse may go on and on and ruin the life of many women. Not reporting crimes is one of the big reasons why crime against women is mounting. So kindly report the crime.

The Doctor-Patient relationship is one of the most trusted, sacred and mutually rewarding alliance. And like all relationships it takes two to keep it going good. Let the patient do his/her part well and let’s hope the doctors do their share well too! The doctors are anyway trained in the do’s and don’t’s in their long years of internship. With this article out, let’s hope the potential patient is also now at least partially trained! And so long live the doctor-patient relationship!